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Childhood grief is one of society's most chronically painful yet most underestimated phenomena. When a child experiences the death of a parent the emotional stress can be devastating. Students are often promoted from grade to grade and the new teachers are sometimes not informed that they are grieving.

Children grieve differently than adults; therefore, adults are unaware of actions that a child may consider insensitive. An example of this would be a school wanting to memorialize the death of a studentâ€™s parent in order to show honor, but the child may be horrified that they are the center of attention and different from everyone else!

The younger a child was at the time of the loss the more likely they were to develop mental health problems including anxiety, mood or substance abuse issues. Positive family relationships and good parenting practices may act as a positive factor against psychopathology following the loss of a parent.

Some children become more resilient, responsible, and independent from the loss theyâ€™ve experienced. In my professional work as a clinician, clients have shared with me the difficulties of dealing with the added responsibilities they now have in running a household, such as cooking and cleaning for shabbos; unlike their peers who have those needs taken care of.

One story stands out in my mind is about the struggles of a girl who was in the 5th grade.Â Her teacher organized a grab bag and the assignment was to bring in a prepared mishloach manot and trade it with the other classmates. She was mortified to being hers in because she had no mother to prepare it for her and she knew hers would be nebby. While everyone's basket was full of nash in elaborate baskets, her nash fit into a little sandwich baggie. When the day arrived to trade, she wished the earth would swallow her up alive in order to bury her embarrassment. The emotion of shame and embarrassment is often felt in children dealing with this type of loss.

OHEL Childrens Home and Family Services conducted a one day training for mental health professionals on this topic with Dr. Norman Blumenthal, Director of Trauma, Bereavement and Crisis Intervention and Dr Zev Brown, a psychologist who specializes in early parental loss. Dr. Brown runs a successful support group in a Yeshiva for high school boys who lost a parent. At the end of the training, Dr. Brown arranged for a student who lost his father and a Rabbi who lost both his parents at a young age, to share their story and describe how comforting the support group is for them.

Links is an organization that publishes a magazine a few times a year. Children and adults have an opportunity to write about their loss and share it with others. They also have a phone support group and a shabbaton. These types of interventions can be very effective in helping children deal with their loss by allowing them to feel comfortable opening up with others who are going through similar issues. How should others be advised to act?Â Many believe that children cannot understand death and lack the capacity to grieve. Because of this misconception, coupled with confusion and anxiety in communicating with children about death, children are often told that the dead parent has simply â€śgone away.â€ť Shielding children from death deprives them of the ability to grieve and ultimately heal.

Furthermore, children re-experience their grief as they reach each milestone in their development. The deceased parent is a â€śmissing pieceâ€ť that the child needs to reconstruct in order to provide himself with a â€śhistory of his past that he could then build on, alter and modify with changing developmental concernsâ€¦.During each succeeding developmental stage, he may need to step back andâ€¦reconstitute the missing pieceâ€ť (Garber, 1988, p. 272).

A childâ€™s ability to understand the meaning and finality of death corresponds to his or her cognitive development. A three to five year old believes that the deceased person has gone away and will return at some point. Therefore, it is common for a child of this age to constantly ask questions such as â€śWhereâ€™s Daddy?â€ť and â€śWhen is Mommy coming home?â€ť

A child of five to approximately nine years of age believes that death can be avoided. Furthermore, a child in this age group also believes that his or her parent died because either the parent was bad or the child was bad, and that if the child is good, the parent can return. This is then seen as one of the most vulnerable and difficult developmental stage for adjusting to a parentâ€™s death. The child at this stage needs someone who can clarify what the child is thinking and feeling, can reframe events to make them more understandable, can reassure and build self-esteem by praising the childâ€™s accomplishments and by emphasizing the childâ€™s importance.

Research has found that children over the age of nine generally have a realistic understanding of the inevitability and finality of death. However, although children over nine years of age understand deathâ€™s finality, their reactions to a parentâ€™s death is determined by their cognitive and emotional level of development and other factors such as gender and the relationship with the surviving parent. (Worden, 1996, pp. 9-10, citing Bowlby (1963, 1980) and R. Furman (1964).

Adolescence is another particularly vulnerable time in the process of adjusting to a parentâ€™s death and in overall development. The adolescentâ€™s profound experience of his or her loss, coupled with adolescent developmental tasks such as separating from family, negotiating a more adult relationship with the surviving parent, finding oneâ€™s identity and true values and deepening relationships with peers, creates a tremendous challenge for the adolescent who is dealing with parental loss. Christ (2000, pp. 190-91)

Adjusting to an Environment without the Deceased Parent

Adjustment is an ongoing process throughout lifeâ€™s transitions.Â The childâ€™s grief will be experienced, and the loss of the parent acutely felt, at times of life transitions such as birthdays, graduation, leaving home, marrying and having a child of oneâ€™s own. Therefore, it is important that parents, caregivers and therapists not minimize the reoccurrence of grief, but to support the child or adult through this new stage of adjusting to life without the parent.

Grief is not a â€śone size fits allâ€ť proposition. Many factors affect a childâ€™s grief process and adjustment to life without the deceased parent. An understanding of these factors and of the childâ€™s emotional and cognitive development is crucial for a therapist or caregiver to support the childâ€™s completion of the tasks of mourning and enable him or her to internalize the â€śmissing pieceâ€ť through grieving and healing.

Sarah Kahan, LCSW Supervisor of OHEL Access at OHEL Childrenâ€™s Home and Family Services. By calling 1(800)603-OHEL, emailing access@ohelfamily.org or visiting www.ohelfamily.org, you can access the breadth of available services.